This bill requires health insurance contracts for groups with more than 50 individuals in New Jersey to include coverage for medically necessary expenses related to the diagnosis and treatment of infertility, as well as for preimplantation genetic testing (PGT) associated with in vitro fertilization (IVF). Notably, this coverage is mandated even for individuals who are not classified as infertile, specifically to prevent the transmission of serious genetic conditions to offspring. The bill outlines conditions under which coverage for IVF and PGT may be limited, such as the age of the covered person and their medical history, while ensuring that benefits are provided at the same level as other pregnancy-related procedures.

Additionally, the bill allows religious employers to request exclusions from coverage that conflicts with their religious beliefs and mandates that health service corporations and health maintenance organizations provide written notice of such exclusions to prospective subscribers. It clarifies that the same copayments, deductibles, and benefit limits that apply to other medical or surgical benefits will also apply to infertility treatments, while excluding infertility resulting from voluntary sterilization procedures. The provisions will take effect 90 days after enactment and will apply to policies or contracts issued or renewed thereafter.

Statutes affected:
Introduced: 17:48-6, 17:48A-7, 17:48E-35.22, 17B:27-46.1, 26:2J-4.23, 52:14-17.29, 52:14-17.46.6